In adults with rapid A-Fib & A-Flutter, what action is recommended when SBP is less than 70 mmHg?

In adults with rapid A-Fib & A-Flutter, what action is recommended when SBP is less than 70 mmHg?

• A. Call Medical Director
• B. Administer Cardizem
• C. Begin Normal Saline IV
• D. Initiate Transcutaneous Pacing

Answer: (A)

When a patient with rapid AFib or AFlutter becomes profoundly hypotensive (SBP < 70 mmHg), they’re unstable and require immediate, physician-guided management. In this scenario, you don’t implement rhythm-suppressing meds on your own or commit to pacing without orders. Drugs like Cardizem can further lower blood pressure and worsen perfusion, so they’re not appropriate first-line choices here. Simply starting IV fluids won’t rapidly correct the dangerous rhythm and may delay definitive treatment. Initiating transcutaneous pacing could be necessary, but the exact intervention and dosing require medical direction. Therefore, the appropriate action is to contact the Medical Director to obtain orders for the correct, rhythm-directed treatment (often involving urgent pacing or cardioversion under medical control).

When a patient with rapid AFib or AFlutter becomes profoundly hypotensive (SBP < 70 mmHg), they’re unstable and require immediate, physician-guided management. In this scenario, you don’t implement rhythm-suppressing meds on your own or commit to pacing without orders. Drugs like Cardizem can further lower blood pressure and worsen perfusion, so they’re not appropriate first-line choices here. Simply starting IV fluids won’t rapidly correct the dangerous rhythm and may delay definitive treatment. Initiating transcutaneous pacing could be necessary, but the exact intervention and dosing require medical direction. Therefore, the appropriate action is to contact the Medical Director to obtain orders for the correct, rhythm-directed treatment (often involving urgent pacing or cardioversion under medical control).